Reader Question: Summer Pneumonia

Question: What exactly is summer pneumonia? Is there a correct ICD-9 diagnosis code for it? Why is this disease so confusing for the billing department of our six-physician infectious disease practice?

Kansas Subscriber

Answer: The term summer pneumonia can be especially confusing for billing and coding departments, because physicians tend to call anything that occurs in the warm weather summer pneumonia or a summer cold. In fact, there is no exact diagnosis of summer pneumonia and neither is there a corresponding ICD-9 code.

The key to coding so-called summer pneumonia is to obtain specific information from the attending physician, such as the causative organism of the pneumonia or whether it is an allergic or inhalation pneumonia, for example.

Provided below is a list of codes for pneumonias that you may encounter during the summer months. As always, a detailed history of illness is the key to appropriate reimbursement. You might use the list below as a template or check list for your physicians. A convenient format such as this should make it easier for you to code and bill for variants of summer pneumonia.

486 Acute pneumonia, primary or secondary
770.0 Acquired infective pneumonia
518.3 Allergic pneumonia (document the allergen)
507.0 Aspiration pneumonia, from gastric secretions
487.0 Atypical influenza pneumonia
482.9 Bacterial pneumonia
483.1 Chlamydial pneumonia
114.0 Coccidioidomycosis pneumonia
481 Diplococcus pneumonia
482.82 E. coli pneumonia
506.0 Inhalation pneumonia, causechemical fumes
482.84 Legionnaires disease
055.1 Post measles pneumonia
482.4 Staphylococcal pneumonia
514 Stasis pneumonia
130.4 Toxoplamosis pneumonia
958.8 Traumatic pneumonia
480.9 Viral pneumonia

- Published on 2000-08-01